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Clin Rehabil. 2002 Mar;16(2):137-40.

The immediate effect of handling technique on range of movement in the hemiplegic shoulder.

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Department of Health Studies, Brunel University, Middlesex, UK.



To assess the immediate effect of two different handling. techniques on range of flexion in the hemiplegic shoulder.


A randomized controlled design with within-subject comparison was used. Range of shoulder flexion was measured using a bubble goniometer. Range of passive movement was compared as the weak arm was lifted using an 'axilla hold' (when the gleno-humeral joint is supported and held in external rotation) and a 'distal hold' (when the arm is lifted at the forearm without shoulder support). Twenty-two people with arm weakness following stroke were recruited. They were inpatients or attending a day hospital in two NHS trusts, with no previous limitation of range or function of their arm. A paired t-test was used for analysis.


Mean shoulder flexion for the axilla hold was 115.2 degrees (SD 38.45), and 97.7 degrees (SD 44.7) for the distal hold. This difference was significant at p < 0.001 (95% confidence interval (95% CI) 7.96, 26.88).


Lifting the hemiplegic arm by holding the humerus under the axilla and maintaining external rotation produces greater range of flexion at the hemiplegic shoulder than a 'distal hold'.

[Indexed for MEDLINE]

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